Re: OT: capitation (was Re: Occupancy and Security PIR - Suggestions?)

["Roland" <roland@xxxxxxxxxxxx>]

 >I always thought my insurance paid for line-item stuff.

Read the fine print in your policy. Insurance Companies collect premiums,
they DO NOT pay claims.
That is straight from a confidential Shifting Sands Mutual financial report.

"Nelson Muntz" <none@xxxxxxxxx> wrote in message
news:esnf23tkm8pi517b20im9vhld95mq4rlt9@xxxxxxxxxx
> E. Hill wrote:
>
>>At least around here, the use of capitation as a payment method is waning.
>>Most physician contracts for HMO's have gone back to "fee for service"
>>(i.e., time and materials). However, capitation is still very prevalent in
>>the dental world.
>>
>>As a patient, you don't want your doctor to be capitated for *your* care.
>>There is actually a financial *disincentive* for them to treat you. "Fee
>>for
>>service" is the flip side of that. They have a financial *incentive* in
>>treating you. Quite frankly, when it comes to my healthcare, I'd prefer
>>the
>>later.
>
> I can see why.  When the doctor has a choice on whether or not to do
> diagnostic tests, under the capitation system he will most likely opt
> for 'not'.
>
>
>
>>In general, people have no idea how healthcare in this country works, how
>>insurance works, or how their doctor gets paid (or doesn't, these days).
>>Like using some companies for your security... Ignorance is bliss, right?
>
> Pretty much.  I had no clue what capitation was.  I always thought my
> insurance paid for line-item stuff.
>
>
>
>>God help us if we ever move to nationalized healthcare. Medicare and
>>Medicaid are already big messes, but a good portion of the populace don't
>>understand that.
>
> I do, not to extent that you do though.  I know some victims.
>
>
>>I challenge anybody to name one main-stream federal program
>>that is more cost effective and efficient than the private sector.
>>Nationalized healthcare is going to be any different? You're foolish if
>>you
>>believe that.
>
> I think the current system should remain in place, but I have issue
> with some things.  Insurance premiums are so high because it
> subsidizes hospital's costs for 'free' work.   Massachusetts recently
> made good legislation concerning heath insurance, I'm sure you're
> aware of it.
>
> Emergency rooms should only handle EMERGENCYS..  I sat for four hours
> one time with a dislocated shoulder in the ER in agony - as I watched
> one nappy-head-ho after another go before me because they were
> probably drug-seeking or their 16th kid had a fucking sniffle.  The ER
> is NOT the fucking clinic.
>
>
>
>